scholarly journals Prevalence of Chronic Kidney Disease and Variation of Its Risk Factors by the Regions in Okayama Prefecture

2022 ◽  
Vol 12 (1) ◽  
pp. 97
Author(s):  
Ryoko Umebayashi ◽  
Haruhito Adam Uchida ◽  
Natsumi Matsuoka-Uchiyama ◽  
Hitoshi Sugiyama ◽  
Jun Wada
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Health Insurance ◽  
Kidney Disease ◽  
National Health Insurance ◽  
National Health ◽  
Health Problems ◽  
Ckd Progression ◽  
Increased Risk ◽  
Okayama Prefecture

Objective: The prevention of chronic kidney disease (CKD) progression is an important issue from health and financial perspectives. We conducted a single-year cross-sectional study to clarify the prevalence of CKD and its risk factors along with variations in these factors among five medical regions in Okayama Prefecture, Japan. Methods and Results: Data concerning the renal function and proteinuria as well as other CKD risk factors were obtained from the database of the Japanese National Health Insurance. The proportion of CKD patients at an increased risk of progression to end-stage renal disease (ESRD), classified as orange and red on the CKD heatmap, ranged from 6–9% and did not vary significantly by the regions. However, the causes of the increased severity differed between regions where renal dysfunction was predominant and regions where there were many patients with proteinuria. CKD risk factors, such as diabetes mellitus, hypertension, hyper low-density lipoprotein-cholesterolemia, obesity, smoking and lack of exercise, also differed among these regions, suggesting that different regions need tailored interventions that suit the characteristics of the region, such as an increased health checkup ratio, dietary guidance and promotion of exercise opportunities. Conclusions: Approximately 6–9% of people are at an increased risk of developing ESRD (orange or red on a CKD heatmap) among the population with National Health Insurance in Okayama Prefecture. The underlying health problems that cause CKD may differ among the regions. Thus, it is necessary to consider intervention methods for preventing CKD progression that are tailored to each region’s health problems.

scholarly journals Changes in Prevalence and Health Checkup Coverage Rate of Chronic Kidney Disease (CKD) after Introduction of Prefecture-Wide CKD Initiative: Results of the Kagawa Association of CKD Initiatives

2021 ◽  
Vol 11 (11) ◽  
pp. 1121
Author(s):  
Tadashi Sofue ◽  
Taiga Hara ◽  
Yoko Nishijima ◽  
Satoshi Nishioka ◽  
Hiroyuki Watatani ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Health Insurance ◽  
Kidney Disease ◽  
National Health Insurance ◽  
National Health ◽  
Coverage Rate ◽  
Medical Visit ◽  
Health Checkup ◽  
Insurance Database ◽  
Special Health

The National Health Insurance (NHI) special health checkup system in Japan targets the NHI population aged 40–74 years. Since 2015, the Kagawa NHI special health checkup was initiated in a prefecture-wide chronic kidney disease (CKD) initiative, including renal examination as an essential item in NHI health checkups. Here, we aimed to investigate the effects of the prefecture-wide CKD initiative. We conducted a retrospective cohort survey using the Kagawa National Health Insurance database created by the Kagawa National Health Insurance Organization. Results of the NHI health checkup (2015–2019) and prefecture-wide outcomes (2013–2019) were analyzed. The prevalence of CKD among examinees who underwent the NHI health checkup increased from 17.7% in 2015 to 23.2% in 2019. The percentage of examinees who completed a medical visit was 29.4% in 2015. After initiation of the initiative, the NHI health checkup coverage rate increased significantly, from a mean (standard deviation) of 40.8% (0.4%) to 43.2% (1.1%) (p = 0.04). After the start of the CKD initiative, we found an increase in the prevalence of CKD and the NHI health checkup coverage rate.

scholarly journals Machine Learning Prediction Models for Chronic Kidney Disease using National Health Insurance Claim Data in Taiwan

2020 ◽  
Author(s):  
Surya Krishnamurthy ◽  
Kapeleshh KS ◽  
Erik Dovgan ◽  
Mitja Luštrek ◽  
Barbara Gradišek Piletič ◽  
...  
Keyword(s):  
Machine Learning ◽  
Chronic Kidney Disease ◽  
Health Insurance ◽  
Kidney Disease ◽  
National Health Insurance ◽  
National Health ◽  
Performance Metrics ◽  
Prediction Models ◽  
Research Database ◽  
Number Of Patients

ABSTRACTBackground and ObjectiveChronic kidney disease (CKD) represent a heavy burden on the healthcare system because of the increasing number of patients, high risk of progression to end-stage renal disease, and poor prognosis of morbidity and mortality. The aim of this study is to develop a machine-learning model that uses the comorbidity and medication data, obtained from Taiwan’s National Health Insurance Research Database, to forecast whether an individual will develop CKD within the next 6 or 12 months, and thus forecast the prevalence in the population.MethodsA total of 18,000 people with CKD and 72,000 people without CKD diagnosis along with the past two years of medication and comorbidity data matched by propensity score were used to build a predicting model. A series of approaches were tested, including Convoluted Neural Networks (CNN). 5-fold cross-validation was used to assess the performance metrics of the algorithms.ResultsBoth for the 6 month and 12-month models, the CNN approach performed best, with the AUROC of 0.957 and 0.954, respectively. The most prominent features in the tree-based models were identified, including diabetes mellitus, age, gout, and medications such as sulfonamides, angiotensins which had an impact on the progression of CKD.ConclusionsThe model proposed in this study can be a useful tool for the policy-makers helping them in predicting the trends of CKD in the population in the next 6 to 12 months. Information provided by this model can allow closely monitoring the people with risk, early detection of CKD, better allocation of resources, and patient-centric management

scholarly journals Income Levels and Mortality Rates in Patients with Chronic Kidney Disease in South Korea: a Population-Based Cohort Study Using National Health Insurance Data

2020 ◽  
Author(s):  
Young Choi
Keyword(s):  
Chronic Kidney Disease ◽  
Health Insurance ◽  
Kidney Disease ◽  
Mortality Rate ◽  
National Health Insurance ◽  
National Health ◽  
Mortality Rates ◽  
Dialysis Patients ◽  
Income Levels ◽  
Low Incomes

Background: To examine the association between income levels and mortality rates in patients with chronic kidney disease. Methods: We analyzed data obtained from 3,172 patients with chronic kidney disease obtained from the Korean National Health Insurance claims database (2003–2009). Each patient was monitored until December 2010 or until death, whichever came first. Individual income was estimated from the national health insurance premium. Information on mortality was obtained from the Korean National Statistical Office. Cox proportional hazard models were used to compare mortality rates between different income groups after adjusting for possible confounding risk factors. Results: A low income was significantly associated with a high mortality rate after adjusting for covariates (adjusted HR 1.298 [1.082–1.556]). In addition, dialysis patients who had low incomes were more likely to have higher mortality rates compared to those in dialysis patients who had high incomes (adjusted HR 1.528 [1.122–2.082]). Conclusion: The findings of this study indicate that chronic kidney disease patients with low incomes have the highest mortality risk. Promotion of targeted policies and priority health services for patients with low incomes may help reduce the mortality rate in this vulnerable group.

Disparities in Kidney Transplantation Access among Korean Patients Initiating Dialysis: A Population-Based Cohort Study Using National Health Insurance Data (2003-2013)

2016 ◽  
Vol 45 (1) ◽  
pp. 32-39 ◽  
Author(s):  
Young Choi ◽  
Jaeyong Shin ◽  
Jung Tak Park ◽  
Kyoung Hee Cho ◽  
Eun-Cheol Park ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Socioeconomic Status ◽  
Kidney Transplantation ◽  
Health Insurance ◽  
Kidney Disease ◽  
South Korea ◽  
National Health Insurance ◽  
National Health ◽  
Income Level ◽  
Kidney Transplants

Background: The socioeconomic status of a person has an impact on his or her access to kidney transplantation as has been reported in western countries. This study examined the association between income level and kidney transplantation among chronic kidney disease patients undergoing dialysis in South Korea. Methods: We analyzed data from 1,792 chronic kidney disease patients undergoing dialysis and listed in the Korean National Health Insurance Claim Database (2003-2013). The likelihood of receiving the first kidney transplant over time was analyzed using competing risk proportional hazard models on time from initiating dialysis to receiving a transplant. Results: Of 1,792 patients on dialysis, only 184 patients (10.3%) received kidney transplants. Patients with medical aid had the lowest kidney transplantation rate (hazard ratio 0.29, 95% CI 0.16-0.51). A lower income level was significantly associated with a low kidney transplantation rate, after adjusting for covariates, compared to patients in the high-income level group. Conclusions: Our findings indicate that in South Korea, the total number of kidney transplants is remarkably low and there exists income disparity with regard to access to kidney transplantation. Thus, we suggest that plans be implemented to encourage organ donation and increase organ transplant accessibility for all patients irrespective of their socioeconomic status.

scholarly journals Risk of chronic kidney disease in patients with obstructive sleep apnea

SLEEP ◽  
2021 ◽  
Author(s):  
Andrew E Beaudin ◽  
Jill K Raneri ◽  
Sofia B Ahmed ◽  
A J Marcus Hirsch Allen ◽  
Andrhea Nocon ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
High Risk ◽  
Kidney Disease ◽  
Ckd Progression ◽  
Obstructive Sleep ◽  
Increased Risk ◽  
Very High

Abstract Study Objectives Chronic kidney disease (CKD) is a global health concern and a major risk factor for cardiovascular morbidity and mortality. Obstructive sleep apnea (OSA) may exacerbate this risk by contributing to the development of CKD. This study investigated the prevalence and patient awareness of the risk of CKD progression in individuals with OSA. Methods Adults referred to five Canadian academic sleep centers for suspected OSA completed a questionnaire, a home sleep apnea test or in-lab polysomnography and provided blood and urine samples for measurement of estimated glomerular filtration rate (eGFR) and the albumin:creatinine ratio (ACR), respectively. The risk of CKD progression was estimated from a heat map incorporating both eGFR and ACR. Results 1295 adults (42% female, 54±13y) were categorized based on the oxygen desaturation index (4% desaturation): <15 (no/mild OSA, n=552), 15-30 (moderate OSA, n=322), and >30 (severe OSA, n=421). After stratification, 13.6% of the no/mild OSA group, 28.9% of the moderate OSA group, and 30.9% of the severe OSA group had a moderate-to-very high risk of CKD progression (p<0.001), which was defined as an eGFR < 60 mL/min/1.73m2, an ACR ≥3 mg/mmol, or both. Compared to those with no/mild OSA, the odds ratio for moderate-to-very high risk of CKD progression was 2.63 (95% CI: 1.79-3.85) for moderate OSA and 2.96 (2.04–4.30) for severe OSA after adjustment for CKD risk factors. Among patients at increased risk of CKD progression, 73% were unaware they had abnormal kidney function. Conclusion Patients with moderate and severe OSA have an increased risk of CKD progression independent of other CKD risk factors; most patients are unaware of this increased risk.

scholarly journals Association of Higher Migraine Risk Among Female and Younger Chronic Osteomyelitis Patients: Evidence from a Taiwan Cohort of One Million

2018 ◽  
Vol 1 (21;1) ◽  
pp. E149-E156
Author(s):  
Chun-Hung Tseng
Keyword(s):  
Risk Factors ◽  
Health Insurance ◽  
Regression Model ◽  
National Health Insurance ◽  
National Health ◽  
Chronic Osteomyelitis ◽  
Hazard Ratio ◽  
Research Database ◽  
Increased Risk ◽  
Taiwan National Health Insurance

Background: Inflammation may trigger migraine development through neurovascular reactions in the brain. Most of the migraine patients, particularly the younger ones, do not have any risk factors for this disease. Hence, we assessed whether chronic osteomyelitis (COM), a chronic inflammatory disease, increases the risk of migraine. Objective: We aim to evaluate the risk of migraine among female and middle-age COM patients with a large patient sample. Study Design: A retrospective cohort study was conducted in this study. Setting: The data used in this study were extracted from the Taiwan National Health Insurance (NHI) Research Database. Methods: A study group with 2,012 COM patients and 8,048 randomly chosen gender- and age-matched controls were chosen from the Taiwan NHI Research Database (NHIRD) from the start of 2000 to the end of 2009. The risk of migraine was estimated with Cox proportional regression model. Both COM and control groups were followed-up until the occurrence of migraine during the study period (2000–2011). Prevalent covariates, such as age, gender, hypertension, diabetes, hyperlipidemia, stroke, coronary artery disease, depression, anxiety, sleep disorder, bipolar disorder, and epilepsy, were included for further evaluation. The hazard ratio (HR) of migraine was measured with Cox proportional hazard regression model. The primary outcome was the overall migraine risk among COM patients, and the secondary outcome was the migraine risk among COM patients lacking the comorbidities. Additional outcomes included migraine risk among COM patients in different age and gender subgroups. Results: The overall migraine risk was increased in COM patients (adjusted hazard ratio [aHR] 1.74, 95% confidence interval [CI] 1.14–2.65). Even without any prevalent comorbidities, COM patients still exhibited an increased risk of migraine (aHR 2.05, 95% CI 1.06–3.97) than the controls did. Moreover, this risk was relatively higher in COM patients aged < 40 and 45–54 years (aHR 2.07, 95% CI 0.97–4.46 and aHR 2.11, 95% CI 0.97–4.57, respectively) than in their counterparts. Female COM patients had a relatively higher migraine risk (aHR 1.85, 95% CI 1.05–3.24) than male patients did (aHR 1.68, 95% CI 0.89–3.16). Limitations: The messages about personal behaviors were unavailable in the Taiwan NHIRD. Other neurovascular risk factors that might increase migraine cannot be excluded completely in this research. Conclusion: An association between COM and increased risk of migraine was shown in this study. The results suggest that COM is a significant migraine predictor, and thus imply the necessity for rigorous migraine prevention in COM patients, especially female and younger ones. Key words: Inflammation, migraine, chronic osteomyelitis, Taiwan National Health Insurance Research Database

scholarly journals Machine Learning Prediction Models for Chronic Kidney Disease Using National Health Insurance Claim Data in Taiwan

Healthcare ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 546
Author(s):  
Surya Krishnamurthy ◽  
Kapeleshh KS ◽  
Erik Dovgan ◽  
Mitja Luštrek ◽  
Barbara Gradišek Piletič ◽  
...  
Keyword(s):  
Machine Learning ◽  
Chronic Kidney Disease ◽  
Health Insurance ◽  
Kidney Disease ◽  
National Health Insurance ◽  
National Health ◽  
Prediction Models ◽  
Research Database ◽  
Close Monitoring ◽  
Number Of Patients

Chronic kidney disease (CKD) represents a heavy burden on the healthcare system because of the increasing number of patients, high risk of progression to end-stage renal disease, and poor prognosis of morbidity and mortality. The aim of this study is to develop a machine-learning model that uses the comorbidity and medication data obtained from Taiwan’s National Health Insurance Research Database to forecast the occurrence of CKD within the next 6 or 12 months before its onset, and hence its prevalence in the population. A total of 18,000 people with CKD and 72,000 people without CKD diagnosis were selected using propensity score matching. Their demographic, medication and comorbidity data from their respective two-year observation period were used to build a predictive model. Among the approaches investigated, the Convolutional Neural Networks (CNN) model performed best with a test set AUROC of 0.957 and 0.954 for the 6-month and 12-month predictions, respectively. The most prominent predictors in the tree-based models were identified, including diabetes mellitus, age, gout, and medications such as sulfonamides and angiotensins. The model proposed in this study could be a useful tool for policymakers in predicting the trends of CKD in the population. The models can allow close monitoring of people at risk, early detection of CKD, better allocation of resources, and patient-centric management.

Stroke in chronic renal failure

2008 ◽  
Vol 149 (15) ◽  
pp. 691-696
Author(s):  
Dániel Bereczki
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Renal Disease ◽  
Chronic Renal Disease ◽  
Kidney Diseases ◽  
Cerebrovascular Diseases ◽  
Lipid Lowering ◽  
Increased Risk ◽  
Intracerebral Hemorrhages

Chronic kidney diseases and cardiovascular diseases have several common risk factors like hypertension and diabetes. In chronic renal disease stroke risk is several times higher than in the average population. The combination of classical risk factors and those characteristic of chronic kidney disease might explain this increased risk. Among acute cerebrovascular diseases intracerebral hemorrhages are more frequent than in those with normal kidney function. The outcome of stroke is worse in chronic kidney disease. The treatment of stroke (thrombolysis, antiplatelet and anticoagulant treatment, statins, etc.) is an area of clinical research in this patient group. There are no reliable data on the application of thrombolysis in acute stroke in patients with chronic renal disease. Aspirin might be administered. Carefulness, individual considerations and lower doses might be appropriate when using other treatments. The condition of the kidney as well as other associated diseases should be considered during administration of antihypertensive and lipid lowering medications.

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